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Eosinophilic Gastrointestinal Diseases

Eosinophilic Gastrointestinal Diseases. ICD-9 Coordination Committee Meeting Baltimore, MD September 28. 2007 Glenn T. Furuta, MD University of Colorado Medical School The Children’s Hospital, Denver. Four points.

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Eosinophilic Gastrointestinal Diseases

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  1. Eosinophilic Gastrointestinal Diseases ICD-9 Coordination Committee Meeting Baltimore, MD September 28. 2007 Glenn T. Furuta, MD University of Colorado Medical School The Children’s Hospital, Denver

  2. Four points • Eosinophilic Gastrointestinal Diseases (EGIDs) impact patient’s quality of life. • Adults and children are affected by these chronic diseases with increasing frequency. • Pathogenesis suggest role for allergy but still not certain; treatment limited to corticosteroids and dietary elimination • Currently, borrowing from other diseases.

  3. “ EGIDs impact patient’s quality of life” Definition- Consensus Statement 2007 • Broad range of symptoms-often confused with other diseases • Histology demonstrates increased eosinophils in intestinal tissue

  4. “ EGIDs impact patient’s quality of life” • Esophagitis- ? • Unresponsive GERD • Feeding problems / slow growth • Dysphagia and food impaction • Gastritis-? • Abdominal pain, bleeding, vomiting • Gastroenteritis and colitis-? • As above • Diarrhea • Swelling • Missed school and Work absenteeism

  5. Eosinophilic Esophagitis“530.13”

  6. Eosinophilic Gastritis“535.41” Eosinophilic Gastroenteritis / Enteritis“558.41”

  7. Eosinophilic Colitis“558.42”

  8. “Adults and children are increasingly affected” • Recent studies identify both rise in incidence and recognition • Familial clustering • Genetic markers

  9. EGIDs publications(1978-2007) Publications Year

  10. “Pathogenesis suggest allergic role; Treatment limited to corticosteroids and dietary elimination” • IgE vs. Non IgE mediated • Long term eosinophilic inflammation associated with fibrosis • Food elimination and / or corticosteroids leads to improvement in many patients.

  11. Pre-endoscopy Post-endoscopy Esophageal Stricture Small caliber esophagus

  12. “Borrowing from other diseases” • Other eosinophilia / esophagitis 288.3 / 530.1 • Allergic gastroenteritis 558.3

  13. “Borrowing from other diseases” • Track-epidemiology • NIH-funding for research • Therapeutic interventions

  14. Four points • Eosinophilic Gastrointestinal Diseases (EGIDs) impact patient’s quality of life. • Adults and children are affected by these chronic diseases with increasing frequency. • Pathogenesis suggest role for allergy but still not certain; treatment limited to corticosteroids and dietary elimination • Currently, borrowing from other diseases.

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